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0 <br />APPENDIX D <br />Spill Report Form <br /> <br />LOCATION: <br /> ate• Time: <br />Regulatory agencies notified (date, time, person, agency, and how): <br /> <br /> <br />Material spilled: <br />Quantity spilled: <br />Source: <br />Cause: <br /> <br /> <br />Extent of injuries (if any): <br />Adverse environmental impact (if any): <br />Immediate remedial actions taken at time of spill: <br />Measures taken or planned to prevent recurrence: <br /> <br />Additional comments: <br /> <br /> <br />This report prepared by: <br />(Signature) <br /> <br />Denison Mines (USA) Corp. <br />Sunday Mines SWMP